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Organization
NICOLET PHARMACY LONG TERM CARE
Active
Organization
NICOLET PHARMACY LONG TERM CARE
Active
Parent organization
NICOLET PHARMACY INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
NICOLET PHARMACY INC
Authorized official
AMY J DONALDSON (PRESIDENT)
(715) 276-3646
Entity
Organization
Contact information
Practice address
15481 COMMERCIAL RD STE A, LAKEWOOD, WI 54138-9677
(715) 276-3646
(715) 276-9568
Mailing address
15481 COMMERCIAL RD STE A, LAKEWOOD, WI 54138-9677
(715) 276-3646
(715) 276-9568
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Enumeration date
07/03/2025
Last updated
07/03/2025
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